“Osteosarcoma is the most common bone cancer that we see in children and teenagers and the problem is that it starts in the bone, but it has the potential to spread…then we worry it can be life-threatening.”

Dr. Dome worked with a team of specialists to ensure Alexx’s treatment was successful and her 16th birthday was sweeter because she also celebrated beating cancer.

Most pediatricians see sarcoma once or twice in the span of their entire career. Our team of sarcoma specialists has the expertise to improve outcomes for young patients with these tumors.

Pediatric soft tissue sarcomas, which can arise in bone, muscle, and connective tissues anywhere in the body, account for just 7 percent of all childhood tumors. Because these tumors can be aggressive, prompt diagnosis and treatment by an experienced multidisciplinary team is needed to provide the best chance for cure and functional recovery.

“If there is a suspected diagnosis of sarcoma, we prefer referral as early as possible,” says Dr. Dome. “If the tumor turns out not to be a sarcoma, families are happy to hear that, but if it is sarcoma, at least we have planned everything from the beginning.”

Children’s National has advanced imaging equipment available for diagnosis, staging, treatment, and follow-up for all bone and soft tissue sarcomas in children, adolescents, and young adults. In addition, the Children’s National sarcoma program is one of the few in the United States where patients can see a pediatric oncologist, orthopaedic oncologist, biologist, and physical therapist in one comprehensive visit.

“Prior to each clinic, individual cases are reviewed by the multidisciplinary team,” says AeRang Kim, MD, PhD, pediatric oncologist at Children’s National. “Then, the patient has access to this team of experts where diagnosis, planning, and treatment can occur with the patient and family.”

Part of Alexx’s team was nurse practitioner Katarina Steacy, NP, NP-C, who was not only familiar with her treatment plan, but also was a point of contact to the family.

“The entire team; the doctor, the nurse practitioner, the nurse coordinator, the social worker, really try to forge a relationship with them from the get-go so that they have hope that we know they can get through this,” says Steacy. “For Alexx, her grandmother and I forged a close relationship and she knew that she could email me or call me with any question or concern throughout her treatment.”

Treatment typically consists of multimodal therapy, which may include chemotherapy, surgery, radiation, and rehabilitation. Patients also have access to the most novel therapies available. As one of the select institutions in the Children’s Oncology Group (COG) consortium, Children’s National has access to COG Phase I and II trials.

“The feat to a successful outcome is having great psychosocial support. It’s not enough to deliver the medicine or the chemotherapy, we also have to support the family and the child,” says Dr. Dome. “For us, just having patients survive the cancer is not enough. We want patients to survive with a good quality of life and full functionality.”

Find this article and others in Advancing Pediatrics, a quarterly publication.

About the Expert

Jeffrey Dome, MD, PhD, is chief of the Division of Oncology and the Division of Hematology. Dr. Dome specializes in pediatric solid tumors, with an emphasis on Wilms tumors and other pediatric kidney tumors. As chair of the Renal Tumor Committee for the Children's Oncology Group (COG), Dr. Dome oversees clinical trials for Wilms tumors and other childhood kidney cancers in more than 200 children's hospitals. He has authored more than 30 articles and textbook chapters on pediatric kidney tumors.